Beta2 antagonist increase insulin release?

Started by TripleB
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TripleB

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In first aid 2012, they changed beta agonists stimulate insulin release to "b2 antagonist increase insulin release"
anyone know the reason behind this?
also why did they take out cortisol increase insulin release in the new edition?
 
In first aid 2012, they changed beta agonists stimulate insulin release to "b2 antagonist increase insulin release"

Where? I remember reading beta 2 function is insulin release in the pharm chapter! How can the opposite be mentioned in the same book? Which chapter did you see it?
 
Actually I'm fairly certain I read it as mentioned above in the Pharmacology chapter in FA2012, which was why I was asking the OP which chapter of the same book he/she got the posted contradictory info from.
Ok, let me clarify: on page 315 on FA 2012, it says "hyperglycemia, GH, and cortisol increase insulin...b-agonists stimulate insulin release" which makes sense to me. In the errata of FA 2012, they changed the text to "Replace the paragraph about Regulation with this: Hyperglycemia, GH, and β2- antagonists increase insulin. Hypoglycemia, somatostatin, and α2-agonists decrease insulin." This is also what is on FA 2013 pg 288.
So I am wondering what caused them to do this.
 
They kept the change in the 2013 version. I tried to look for recent journal articles on this and I couldn't find any. Does anyone know what prompted the change in the first place?
 
The most high yeild connection between beta-2 antagonists and the pancreas/insulin is probably that:

Non-specific (B1/B2) Antagonists, like propranolol, should not be used in diabetic patients, as they mask the early adrenergic side effects of HYPOglycemia. Hypoglycemia triggers catechols which cause tachycardia, diaphoresis, anxiety, etc. early on. This can be very dangerous in these patients, if these symptoms are masked.

This seems like the most logical clinical scenario that would come up on the boards. I just can't see them asking flat out, "Do Beta-antagonists increase or decrease insulin release in the pancreas?" Try and think of "how" they would ask the question. Figure out "why" its important clinically.

And, another thing. Remeber that although Beta-2 adrenergic Agonists can cause insulin release from the pancreas, they also stimulate Glycogenolysis in the liver, which can lead to hyperglycemia. At least, this is what i can remember on the subject. I think these would be more of the systemic Beta-2 agonists, like PO Albuterol and Clenbuterol and not the aerosolized kind used in acute asthma management. Typically not going to see hyperglycemia in an asthmatic, unless they are on PO steroids or they just took 15 puffs of their inhaler.
 
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Oh, and I forgot one other important fact:

Glucagon is the tx for Beta-blocker toxicity. Just think about it, and see if you can piece together how Beta-Antagonists affect insulin release/Hypoglycemia...